Inner Room Somatic Therapy

LGB and Gener Non-Conforming Persons


Why I'm not enthusiastic about gender pronouns

The very recent trend to announce our gender identity pronouns is usually very well intentioned. We want to be inclusive and respectful if someone in the room or space presents differently than their "actual" gender and when everyone or most people identify their pronouns by default, an inclusive environment is promoted for those who might use they/them pronouns or opposite-gender pronouns from the sex they appear to be.

Well intentioned as this practice may be, I believe that it promotes and encourages confusion, especially among young people.  In many social circles, there is pressure to use they/them pronouns, even if only she/they or he/they.  It often feels as though those who remain "stuck in the male-female gender binary" are out of touch, behind the times, or simply not very thoughtful in exploring the dimensions of their own gender. 

So, you might say, what's the harm?  Without going into great detail, these are my three main concerns with the now widespread use of pronouns: 1) the practice tells us we can't trust out own senses about the person we are in the presence of, 2)  the practice promotes gender questioning and confusion among especially young people and very likely contributes to the higher rates of gender dysphoria, gender transition, and accordingly, rates of regret and detransition, and 3) use of pronouns is frequently imposed on people rather than offered as a free choice or invitation. Not always but often enough it really feels like coercion and I'm really reluctant to say yes to coercion. 

Regret and Detransition

There are a range of statistics you could use to describe the frequency of regret and/or detransition, ranging from less than 2% to 4 out of 10. However, one thing is sure, the presence of any number of detransitioners means that for many people, the irreversable "gender affirming" interventions that include puberty blockers, cross-sex hormones, and surgeries to remove healthy breast tissues and healthy genital organs are an absolute disaster.  

It is therefore encumbant upon all of us, especially those of us in the medical and helping professions, to listen to the stories of detransitioners and those who experience sometimes extreme regret, to become much better informed about the very serious side effects and consequences of these experimental interventions, and to work to support de-transitioners much more fully than we do today.

Articles and Websites

https://pitt.substack.com/

https://genspect.org/docs/

https://www.genderhq.org/

Literature Review Topics

  1. “The Dutch Study”: (i) de Vries, A. L. C., Steensma, et al (2011). Puberty suppression in adolescents with gender identity disorder: A prospective follow up study. (ii) de Vries, A. L. C., McGuire, J. K., Steensma, et al. (2014). Young adult psychological outcome after puberty suppression and gender reassignment.

    Refutations:

    1. Abbruzzese, Levine, & Mason (2023) The Myth of “Reliable Research” in Pediatric Gender Medicine: A critical evaluation of the Dutch Studies and research that has followed.

    2. Levine, Abbruzzese, & Mason (2022). Reconsidering informed consent for trans-identified children, adolescents, and young adults.

    3. SEGM (2023) The Dutch Studies and The Myth of Reliable Research in Pediatric Gender Medicine.

    4. Sapir, L. (2022) The Distortions in Jack Turban’s Psychology Today Article on ‘Gender Affirming Care’. Reality's Last Stand. (study #1 & #2)

    5. Singal., J. (2022) "Science Vs" Cited Seven Studies To Argue There’s No Controversy About Giving Puberty Blockers And Hormones To Trans Youth. (study 3)

    6. Genspect (2022) Constructive Criticism For Psychology Today. (study 2)

    7. Biggs., M. (2022) The Dutch Protocol for Juvenile Transsexuals: Origins and Evidence.

    8. NICE - (2020) Evidence review: Gonadotrophin releasing hormone analogues for children and adolescents with gender dysphoria. UK National Institute for Care and Excellence, (Document commissioned by NHS England and Improvement who commissioned the Cass review.) chapter 5, p. 19- 26.

  2. Cornell University (2018) “What Does the Scholarly Research Say about the Effect of Gender Transition on Transgender Well-Being?” (online literature review)

    Refutations:

    1. JLCederblom (2020) What we know about “What We Know”. 

    2. Horvath, H (2020) Activist-driven transgender research methods are reckless and will lead to harms. ResearchGate.

  3. Tordoff et al. (2022) Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care.

    Refutations:

    1. Singal, J. (2022) Researchers Found Puberty Blockers And Hormones Didn’t Improve Trans Kids’ Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite; A critique of Tordoff et al.

    2. Sapir, L. (2022) The Distortions in Jack Turban’s Psychology Today Article on ‘Gender AffirmingCare’. (study #16)

    3. Abbruzzese, E., Levine, S.B., & Mason, J.M. (2023) The Myth of “Reliable Research” in Pediatric Gender Medicine: A critical evaluation of the Dutch Studies and research that has followed. 

  4. “The Psychology Today Article”. Turban, J. (2022) The Evidence for Trans Youth Gender-Affirming Medical Care. 

    Refutations:

    1. Genspect (2022) Constructive Criticism For Psychology Today.

    2. Sapir, L. (2022) The Distortions in Jack Turban’s Psychology Today Article on ‘Gender Affirming Care’.

  5. Bauer et al. (2022) Do Clinical Data from Transgender Adolescents Support the Phenomenon of "Rapid Onset Gender Dysphoria"?

    Refutations

    1. Sinai., J. (2022) Rapid onset gender dysphoria as a distinct clinical phenomenon.

    2. Littman, L. (2022) Saying that Bauer et al studied rapid onset gender dysphoria is inaccurate and misleading.

  6. Rew et al (2021). Review: Puberty blockers for transgender and gender diverse youth – a critical review of the literature.

    Refutation:

    1. Clayton et al (2021). Commentary: The Signal and the Noise—questioning the benefits of puberty blockers for youth with gender dysphoria—a commentary on Rew et al. (2021).

  7. Bustos et al. (2021) Regret after gender-affirmation surgery: a systematic review and meta-analysis of prevalence.

    Refutations:

    1. Expósito-Campos, & D’Angelo (2021). Letter to the Editor: Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence. 

    2. JLCederblom (2022) At what point does incompetence become fraud?

  8. Olson et al (2022) Gender Identity 5 Years After Social Transition.

    Refutation:

    1. SEGM (2022) Early Social Gender Transition in Children is Associated with High Rates of Transgender Identity in Early Adolescence: A new study lends credibility to concerns that early social gender transition can lead to persistence of pediatric gender dysphoria.

  9. van der Loos et al (2023) Children and adolescents in the Amsterdam Cohort of Gender Dysphoria: trends in diagnostic- and treatment trajectories during the first 20 years of the Dutch Protocol.

    Refutation:

    1. SEGM (2023) New "20-year" Study from Amsterdam's VUmc Youth Gender Clinic: A Critical Analysis: The study's conclusions and "clinical implications" are not supported by the data presented.

  10. Bränström & Pachankis (2020). Reduction in mental health treatment utilization among transgender individuals after gender-affirming surgeries: A total population study.

    Refutations:

    1. Correction to Bränström and Pachankis (2020) American Journal of Psychiatry.

    2. Van Mol et al (2020) Correction: Transgender Surgery Provides No Mental Health Benefit.

    3. Regnerus, M. (2019) New Data Show “Gender-Affirming” Surgery Doesn’t Really Improve Mental Health. So Why Are the Study’s Authors Saying It Does?

    4. Anderson, R.T. (2020) “Transitioning” Procedures Don’t Help Mental Health, Largest Dataset Shows.

    5. SEGM (2020) Correction of a Key Study: No Evidence of “Gender-Affirming” Surgeries Improving Mental Health.

  11. Costa et al (2015). Psychological support, puberty suppression, and psychosocial functioning in adolescents with gender dysphoria.

    Refutations:

    1. Sapir, L. (2022) The Distortions in Jack Turban’s Psychology Today Article on ‘Gender Affirming Care’. (study #3)

    2. Singal., J. (2022) "Science Vs" Cited Seven Studies To Argue There’s No Controversy About Giving Puberty Blockers And Hormones To Trans Youth. Let’s Read Them. (study 4).

    3. Biggs., (2019) A Letter to the Editor Regarding the Original Article by Costa et al: Psychological Support, Puberty Suppression, and Psychosocial Functioning in Adolescents with Gender Dysphoria.

    4. NICE - (2020) Evidence review: Gonadotrophin releasing hormone analogues for children and adolescents with gender dysphoria. UK National Institute for Care and Excellence, chapter 5, p. 21-29.

  12. Allen et al (2019). Well-being and suicidality among transgender youth after gender-affirming hormones.

    Refutations:

    1. Sapir, L. (2022) The Distortions in Jack Turban’s Psychology Today Article on ‘Gender Affirming Care’. (study #4)

    2. NICE (2020) Evidence review: Gender-affirming hormones for children and adolescents with gender dysphoria. UK National Institute for Care and Excellence,  chapter 5, p. 21-29.

  13. Kaltiala et al (2020). Adolescent development and psychosocial functioning after starting cross-sex hormones for gender dysphoria.

    Refutations:

    1. Sapir, L. (2022) The Distortions in Jack Turban’s Psychology Today Article on ‘Gender Affirming Care’. (study #5)

    2. NICE (2020) Evidence review: Gender-affirming hormones for children and adolescents with gender dysphoria. UK National Institute for Care and Excellence, chapter 5, p. 21-29.

  14. de Lara et al (2020). Psychosocial assessment in transgender adolescents.

    Refutations:

    1. Sapir, L. (2022) The Distortions in Jack Turban’s Psychology Today Article on ‘Gender Affirming Care’. (study #6)

    2. NICE (2020) Evidence review: Gender-affirming hormones for children and adolescents with gender dysphoria. UK National Institute for Care and Excellence, chapter 5, p. 21-29.

  15. van der Miesen et al (2020). Psychological functioning in transgender adolescents before and after gender-affirmative care compared with cisgender general population peers.

    Refutations:

    1. Sapir, L. (2022) The Distortions in Jack Turban’s Psychology Today Article on ‘Gender Affirming Care’. Reality's Last Stand. (study #7)

    2. Genspect (2022) Constructive Criticism For Psychology Today. (study 7).

  16. Achille, C., Taggart, et al (2020). Longitudinal impact of gender-affirming endocrine intervention on the mental health and well-being of transgender youths: preliminary results. 

    Refutations:

    1. Sapir, L. (2022) The Distortions in Jack Turban’s Psychology Today Article on ‘Gender Affirming Care’. (study #8).

    2. Singal., J. (2022) "Science Vs" Cited Seven Studies To Argue There’s No Controversy About Giving Puberty Blockers And Hormones To Trans Youth. Let’s Read Them. (study 5).

    3. NICE (2020) Evidence review: Gender-affirming hormones for children and adolescents with gender dysphoria. UK National Institute for Care and Excellence, chapter 5, p. 21-29.

  17. Kuper, L. E., Stewart et al (2020). Body dissatisfaction and mental health outcomes of youth on gender-affirming hormone therapy.

    Refutations:

    1. Sapir, L. (2022) The Distortions in Jack Turban’s Psychology Today Article on ‘Gender Affirming Care’. Reality's Last Stand. (study #9)

    2. Singal., J. (2022) "Science Vs" Cited Seven Studies To Argue There’s No Controversy About Giving Puberty Blockers And Hormones To Trans Youth. Let’s Read Them. Singal-Minded (study 2).

    3. NICE (2020) Evidence review: Gender-affirming hormones for children and adolescents with gender dysphoria. UK National Institute for Care and Excellence, chapter 5, p. 21-29.

  18. Turban, J. L., King, et al (2020). Pubertal suppression for transgender youth and risk of suicidal ideation.

    Refutations:

    1. Biggs, M. (2020) Puberty Blockers and Suicidality in Adolescents Suffering from Gender Dysphoria.

    2. Sapir, L. (2022) The Distortions in Jack Turban’s Psychology Today Article on ‘Gender Affirming Care’. Reality's Last Stand. (study #10).

    3. Genspect (2022) Constructive Criticism For Psychology Today. (study 10)

  19. Carmichael et al (2021). Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK.

    Refutations:

    1. Sapir, L. (2022) The Distortions in Jack Turban’s Psychology Today Article on ‘Gender Affirming Care’. (study #11).

    2. Genspect (2022) Constructive Criticism For Psychology Today. (study 11)

  20. Grannis et al (2021). Testosterone treatment, internalizing symptoms, and body image dissatisfaction in transgender boys.

    Refutations:

    1. Sapir, L. (2022) The Distortions in Jack Turban’s Psychology Today Article on ‘Gender Affirming Care’. Reality's Last Stand. (study #12).

    2. Genspect (2022) Constructive Criticism For Psychology Today. (study 12)

  21. Hisle-Gorman et al (2021). Mental healthcare utilization of transgender youth before and after affirming treatment.

    Refutations:

    1. Sapir, L. (2022) The Distortions in Jack Turban’s Psychology Today Article on ‘Gender Affirming Care’. (study #13).

    2. Genspect (2022) Constructive Criticism For Psychology Today. (study 13)

  22. Green, DeChants et al (2021). Association of gender-affirming hormone therapy with depression, thoughts of suicide, and attempted suicide among transgender and nonbinary youth.

    Refutations:

    1. Sapir, L. (2022) The Distortions in Jack Turban’s Psychology Today Article on ‘Gender Affirming Care’. (study #14).

    2. Genspect (2022) Constructive Criticism For Psychology Today. (study 14)

    3. Genspect (2021) A Parent Responds To TIME Article On Poorly Designed Trevor Project Survey.

  23. Turban, King et al (2022). Access to gender-affirming hormones during adolescence and mental health outcomes among transgender adults.

    Refutations:

    1. Biggs., M. (2022) Reader comments: Estrogen is associated with greater suicidality among transgender males, and puberty suppression is not associated with better mental health outcomes for either sex.

    2. Sapir, L. (2022) The Distortions in Jack Turban’s Psychology Today Article on ‘Gender Affirming Care’. (study #15).

    3. Singal., J. (2022) "Science Vs" Cited Seven Studies To Argue There’s No Controversy About Giving Puberty Blockers And Hormones To Trans Youth. Let’s Read Them. (study 6).

    4. Genspect (2022) Constructive Criticism For Psychology Today. (study 15)

  24. Turban, Beckwith.et al (2022) Association Between Recalled Exposure to Gender Identity Conversion Efforts and Psychological Distress and Suicide Attempts Among Transgender Adults.

    Refutation:

    1. Singal., J. (2022) "Science Vs" Cited Seven Studies To Argue There’s No Controversy About Giving Puberty Blockers And Hormones To Trans Youth. Let’s Read Them. (study 1).

  25. Rosenthal S.M. (2021) Challenges in the care of transgender and gender-diverse youth: an endocrinologist's view.

    1. Cohn. J. (2022) Some Limitations of "Challenges in the Care of Transgender and Gender-Diverse Youth: An Endocrinologist's View".

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